{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:07:54Z","timestamp":1758931674402,"version":"3.44.0"},"reference-count":0,"publisher":"Romanian Society of Gastroenterology and Hepatology","issue":"3","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JGLD"],"abstract":"<jats:p>Background and Aims: Chronic atrophic gastritis (CAG) is a known precancerous condition that can lead to the development of gastric cancer (GC). Low serum pepsinogen (PG) I levels have been proposed as a non-invasive marker for chronic atrophic gastritis of the stomach body, but the adequate upper cut-off for diagnosis remains controversial, as values ranging from 30 to 50 mcg\/L are currently considered as a \u201cgrey zone\u201d. We aimed to identify patients with chronic atrophic gastritis (CAG) of the stomach body amongst subjects with PG-I levels ranging between 30 and 50 mcg\/L by means of a proton pump inhibitor (PPI) challenge.\nMethods: We selected 102 patients with baseline PG-I &lt;60 mcg\/L in whom upper gastrointestinal endoscopy with protocol biopsies staged according to OLGA system had been performed. Subsequently, all patients underwent a PPI challenge (consisting of PG-I testing after taking Esomeprazole 40 mg daily for 1 week). This population was divided into 5 groups according to PG-I levels: group A (PG-I&lt; 30 mcg\/L); group B (PG-I: 31-35 mcg\/L); group C (PG-I: 36-40 mcg\/L); group D (PG-I: 41-50 mcg\/L); group E (PG-I: 51-60 mcg\/L). By using the ROC curve, a cut-off of 30% increase from baseline PG-I was chosen. Results: A statistically significant relationship between PG-I levels and OLGA staging was found, being 100% in the group of PG-I &lt; 30mcg\/L. Based on the value of the cut-off of 30% (calculated by ROC curve) corresponding to the delta increase between PG-I baseline value and after a one-week full dose of PPI, the positive predictive value was 95%, the negative predictive value 86%, the sensitivity 83% and the specificity 96%.\nConclusions: The use of the PPI challenge allows to identify subjects with CAG showing pepsinogen I values ranging between 30 and 50 mcg\/L.<\/jats:p>","DOI":"10.15403\/jgld-6212","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T21:40:52Z","timestamp":1755812452000},"page":"287-294","source":"Crossref","is-referenced-by-count":0,"title":["Proton Pump Inhibitor Challenge to Confirm Diagnosis of Atrophic Gastritis of the Stomach: A Proposal"],"prefix":"10.15403","volume":"34","author":[{"given":"Francesco","family":"Di Mario","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilisa","family":"Franceschi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kryssia Isabel","family":"Rodriguez-Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Piera","family":"Panozzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ferronato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Violi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorella","family":"Franzoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Tursi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Brandimarte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pellegrino","family":"Crafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6121","published-online":{"date-parts":[[2025,8,22]]},"container-title":["Journal of Gastrointestinal and Liver Diseases"],"original-title":[],"link":[{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/6212\/2214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/6212\/2214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T12:05:13Z","timestamp":1758888313000},"score":1,"resource":{"primary":{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/view\/6212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,26]]}},"URL":"https:\/\/doi.org\/10.15403\/jgld-6212","relation":{},"ISSN":["1842-1121","1841-8724"],"issn-type":[{"type":"electronic","value":"1842-1121"},{"type":"print","value":"1841-8724"}],"subject":[],"published":{"date-parts":[[2025,8,22]]}}}